Provider Demographics
NPI:1447373352
Name:HECHT-GARCIA, SANDI ROSE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SANDI
Middle Name:ROSE
Last Name:HECHT-GARCIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 TUTHILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:ELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12428
Mailing Address - Country:US
Mailing Address - Phone:845-647-3394
Mailing Address - Fax:845-647-3394
Practice Address - Street 1:22 N MAIN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-1058
Practice Address - Country:US
Practice Address - Phone:845-647-3394
Practice Address - Fax:845-647-3394
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0387051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN4I641Medicare UPIN
NYA300067409Medicare PIN